The nurse administers an incorrect dose of medication to a patient. After assessing the patient, the nurse calls the physician to report the occurrence and then notifies the nursing supervisor about the medication error and completes an incident report. The nurse's manager takes a Quality Management (QM) approach. Which of the following is not a principle of QM?

Choice A reason: A formalized competency program with established standards for practice ensures that all nurses meet a certain level of proficiency and adhere to the same high standards, which is essential for preventing clinical incompetence.

Choice B reason: While a standardized clinical skills checklist can be a useful tool for assessing specific skills, it does not encompass the comprehensive approach of a formalized competency program.

Choice C reason: Personality tests and competency assessments at the point of hire can help in selecting competent staff, but they are not sufficient on their own to prevent clinical incompetence throughout an employee's tenure.

Choice D reason: A flexible protocol for evaluating competency skills may allow for individualized assessment, but without established standards, it may not effectively prevent clinical incompetence.

Choice A reason: This choice is incorrect because effective followership involves questioning and providing feedback to leaders, which can lead to improved decision-making and innovation.

Choice B reason: This is the correct choice. In the context of nursing, leaders often take on the role of followers as well. They collaborate with other leaders and sometimes follow directives from higher management or adhere to policies, showing that leadership is not a one-way process but a dynamic interchange.

Choice C reason: This choice is incorrect. While followers do need structure, it does not necessarily have to be linear. Effective followership encourages independent critical thinking and active engagement, which can lead to job satisfaction and better patient outcomes.

Choice D reason: This choice is partially correct. While leaders should provide guidance to new staff, it is also important for leaders to encourage autonomy and critical thinking, allowing new staff to develop their skills and confidence.